Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure
Introduction. An expanding number of indications for PCI in patients with coronary heart disease and severe concomitant pathology are accompanied by a growing number of patients with chronic renal failure. Contrast-induced nephropathy (CIN) is recognized as a severe complication, aggravating the cou...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bashkir State Medical University
2023-12-01
|
| Series: | Креативная хирургия и онкология |
| Subjects: | |
| Online Access: | https://www.surgonco.ru/jour/article/view/866 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849249699744186368 |
|---|---|
| author | D. K. Vasiliev B. A. Rudenko D. A. Feshchenko F. B. Shukurov A. S. Shanoyan |
| author_facet | D. K. Vasiliev B. A. Rudenko D. A. Feshchenko F. B. Shukurov A. S. Shanoyan |
| author_sort | D. K. Vasiliev |
| collection | DOAJ |
| description | Introduction. An expanding number of indications for PCI in patients with coronary heart disease and severe concomitant pathology are accompanied by a growing number of patients with chronic renal failure. Contrast-induced nephropathy (CIN) is recognized as a severe complication, aggravating the course of the underlying disease, and, moreover, reducing the life expectancy of the patients. Modern intravascular imaging technologies are widely implemented in real clinical practice of endovascular surgery. In the context of increasing number of PCI performed in patients with severe concomitant pathology, the IVUS-guidance will improve the quality of stenting, and, importantly, lessen the risks of CIN due to the reduction in contrast volume. Materials and methods. The paper presents a clinical case of IVUSguided stenting of the right coronary artery without contrast agent in a patient with chronic kidney disease and the following diagnosis: “Coronary heart disease. Effort angina, class III (dyspnea as anginal equivalent). Balloon angioplasty and stenting of circumflex artery and LAD. Hyperlipidemia 2a. Atherosclerosis of the aorta, brachiocephalic and coronary arteries. Stage 3 hypertension. Controlled Hypertension. Level IV CVD risk. Type 2 diabetes mellitus. Target glycated hemoglobin is less than 7.5%. Grade 2 obesity, exogenous-constitutional. Renal microlithiasis. CKD stage 4 (GFR 29 ml/min/1.73m2). Cerebrovascular disease. Chronic cerebral ischemia.” Results and discussion. In the described clinical case, a complete myocardial revascularization was achieved using IVUS-guidance and minimal amount of contrast agent in a patient with severe CKD. The advantage of minimally invasive endovascular interventions in a complex category of patients, demonstrated by the case, implies expanded possibilities for providing high-tech care to patients with significant limitations in the use of contrast agents due to severe CKD with a high risk of CIN. Conclusion. Today, an increasing number of X-ray operating rooms in Russia are equipped with intravascular technologies, ensuring their wider use. The skills and knowledge in using IVUS imply rare application of contrast agents, thereby lessening the risk of CKD and, as a consequence, improving the prognosis of patients with reduced renal function and high risk of CKD. |
| format | Article |
| id | doaj-art-bc3c0e7630b742b0a26392fa8083369a |
| institution | Kabale University |
| issn | 2076-3093 2307-0501 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Bashkir State Medical University |
| record_format | Article |
| series | Креативная хирургия и онкология |
| spelling | doaj-art-bc3c0e7630b742b0a26392fa8083369a2025-08-20T03:57:27ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012023-12-0113434234710.24060/2076-3093-2023-13-4-342-347556Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal FailureD. K. Vasiliev0B. A. Rudenko1D. A. Feshchenko2F. B. Shukurov3A. S. Shanoyan4National Medical Research Center for Therapy and Preventive MedicineNational Medical Research Center for Therapy and Preventive MedicineNational Medical Research Center for Therapy and Preventive MedicineNational Medical Research Center for Therapy and Preventive MedicineNational Medical Research Center for Therapy and Preventive MedicineIntroduction. An expanding number of indications for PCI in patients with coronary heart disease and severe concomitant pathology are accompanied by a growing number of patients with chronic renal failure. Contrast-induced nephropathy (CIN) is recognized as a severe complication, aggravating the course of the underlying disease, and, moreover, reducing the life expectancy of the patients. Modern intravascular imaging technologies are widely implemented in real clinical practice of endovascular surgery. In the context of increasing number of PCI performed in patients with severe concomitant pathology, the IVUS-guidance will improve the quality of stenting, and, importantly, lessen the risks of CIN due to the reduction in contrast volume. Materials and methods. The paper presents a clinical case of IVUSguided stenting of the right coronary artery without contrast agent in a patient with chronic kidney disease and the following diagnosis: “Coronary heart disease. Effort angina, class III (dyspnea as anginal equivalent). Balloon angioplasty and stenting of circumflex artery and LAD. Hyperlipidemia 2a. Atherosclerosis of the aorta, brachiocephalic and coronary arteries. Stage 3 hypertension. Controlled Hypertension. Level IV CVD risk. Type 2 diabetes mellitus. Target glycated hemoglobin is less than 7.5%. Grade 2 obesity, exogenous-constitutional. Renal microlithiasis. CKD stage 4 (GFR 29 ml/min/1.73m2). Cerebrovascular disease. Chronic cerebral ischemia.” Results and discussion. In the described clinical case, a complete myocardial revascularization was achieved using IVUS-guidance and minimal amount of contrast agent in a patient with severe CKD. The advantage of minimally invasive endovascular interventions in a complex category of patients, demonstrated by the case, implies expanded possibilities for providing high-tech care to patients with significant limitations in the use of contrast agents due to severe CKD with a high risk of CIN. Conclusion. Today, an increasing number of X-ray operating rooms in Russia are equipped with intravascular technologies, ensuring their wider use. The skills and knowledge in using IVUS imply rare application of contrast agents, thereby lessening the risk of CKD and, as a consequence, improving the prognosis of patients with reduced renal function and high risk of CKD.https://www.surgonco.ru/jour/article/view/866percutaneous coronary interventioncoronary heart diseasechronic kidney diseaseintravascular ultrasoundcontrast mediacontrast-induced nephropathy |
| spellingShingle | D. K. Vasiliev B. A. Rudenko D. A. Feshchenko F. B. Shukurov A. S. Shanoyan Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure Креативная хирургия и онкология percutaneous coronary intervention coronary heart disease chronic kidney disease intravascular ultrasound contrast media contrast-induced nephropathy |
| title | Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure |
| title_full | Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure |
| title_fullStr | Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure |
| title_full_unstemmed | Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure |
| title_short | Clinical Case of IVUS-Guided Coronary Artery Stenting in a Patient with Chronic Renal Failure |
| title_sort | clinical case of ivus guided coronary artery stenting in a patient with chronic renal failure |
| topic | percutaneous coronary intervention coronary heart disease chronic kidney disease intravascular ultrasound contrast media contrast-induced nephropathy |
| url | https://www.surgonco.ru/jour/article/view/866 |
| work_keys_str_mv | AT dkvasiliev clinicalcaseofivusguidedcoronaryarterystentinginapatientwithchronicrenalfailure AT barudenko clinicalcaseofivusguidedcoronaryarterystentinginapatientwithchronicrenalfailure AT dafeshchenko clinicalcaseofivusguidedcoronaryarterystentinginapatientwithchronicrenalfailure AT fbshukurov clinicalcaseofivusguidedcoronaryarterystentinginapatientwithchronicrenalfailure AT asshanoyan clinicalcaseofivusguidedcoronaryarterystentinginapatientwithchronicrenalfailure |